Failure to Cleanse Skin Before Treatment and Delay in Psychotropic Medication Administration
Penalty
Summary
The facility failed to provide appropriate treatment and care according to physician orders and resident preferences for two residents. In the first instance, a wound care nurse applied Nystatin ointment to a resident's back, buttocks, and groin without thoroughly cleansing the skin beforehand. Observations revealed multiple areas of redness, clumps of dead skin, sweat, and remnants of old cream on the resident's skin, as well as yellow fluid stains on the bedding. Staff acknowledged that the skin should have been cleansed more thoroughly prior to the application of the antifungal cream, as per the physician's order for treatment of a fungal rash. In the second instance, a resident with a history of schizoaffective disorder and anxiety disorder did not receive her prescribed Lorazepam for several days. The resident reported not receiving the medication for six days, receiving the wrong dose when it was delivered, and experiencing anxiety and anger due to the delay. Facility records confirmed that Lorazepam was not administered as ordered on multiple dates, despite the facility having an emergency supply available. The facility's policy requires medications to be administered within one hour of the prescribed time, but this was not followed for the resident's psychotropic medication.